Yeah, and cost of health insurance in Austria is just 7,65% of your income, and it covers your children. When I've worked in the US, I've paid just as much for health insurance and still had high out-of-pockets and deductibles on top of that.
I will pay $4,800 to cover a family of 4. If I need to use it, I have a $6,000 deductible (company pays first $4k and I pay last $2k). All doctor visits are 100% deductible until it is fully paid, then $50 / visit. The HSA can be used to pay the deductible and pharmacy costs.
Yup, and that's about what you pay for a single person health insurance in the US that isn't very high deductible. I think my employer pays about $6K/yr for me and another $6K/yr for my partner, (I know this 'cause I've gotta pay taxes on hers, as we're not married) but it's a reasonably good plan. Same provider, but more expensive/better coverage when I was buying through my own company. When I see the doctor, they charge me a symbolic fee, but it's usually around what the ride share to get there costs me. (the parking there, ugh.)
Personally, I avoid the very high deductible plans, mostly because I have the option, but also because I don't want to deal with hospital billing. I've got an HMO (kaiser) and they charge me almost nothing at point of service, and I get to consume all the medical care my doctor thinks I need.
Unfortunately, my employer has a really juicy high deductible plan that a lot of my co-workers use. Like they actually give you money to put in your HSA that covers most of your high deductible. It's a good plan. But I don't like it because it means my co-workers get to keep extra money for not going to the doctor when they are sick, and instead they come into the open plan office and cough all over the place.
I mean, I do okay, and I'd be happy to kick in a little extra money if it meant my co-workers were more likely to go to the doctor when they are sick rather than sharing the love with the office.
Just because they don't go to the doctor doesn't mean the have to come into the office, unless you have a terrible employer...
I hate policies that require a doctors note. Yeah, I have the flu, going to the doctor is just going to spread it, unless I have some sort of complication.
True, but I think they are both symptoms of skimping on medical care, which I don't think people should have to do in general. (I would be happy to pay more taxes to make that happen.) I especially think people shouldn't ration medical care where I work; I suspect the median annual income here is closer to $200k than to $100k.
When you are sick, don't go to work. If there is any question of if the doctor can help, talk to the doctor. (Via phone or video chat, if necessary)
For me it's the opposite. I moved from Denmark to the US, and I pay around $400 in health insurance premiums (health, eye, and dental) for a whole family. In Denmark, only health is covered, so for eye and dental many go out-of-country to get it cheap.
The US is much cheaper for all health insurances, except if your poor. Obama tried to fix that, but made it worse and more expensive for everyone (socialism).
If you're employed and your employer is generous, then your insurance premiums can be inexpensive (low double digits per month if you're single, low triple digits if you have dependents) . My wild speculation is that most employers aren't as generous as they could be.
If you're "poor", insurance is actually cheap, because that's when you get public insurance. However, if you're just middle income, health care is a non-trivial portion of your income. One major health incident will bankrupt you and you're likely to become poor. But once you're poor, hey, you can get cheap health insurance.
The critical problem is that obtaining reasonable health insurance requires you to be employed full time at a large company. This must stop. Obamacare was a first step toward cutting the employer out of the picture.
When I made less than $30k/year in Los Angeles and had Obamacare, I was paying $144/month to see a nurse associated with a second rate doctor (I also went to a couple urgent care facilities with nearly the same level of quality). The wait times were an average of two hours and I paid at least $75 /visit without any real resolution to my allergy problems. I probably had 10 visits without that needed resolution.
When I became a salaried employee in the Bay area I went to an urgent care recommended by Cigna and my allergy problems were resolved inside of 15 minutes with a $20 copay.
Obamacare is anything but cheap when you are poor.
The last step is a full-coverage default public option, paid for out of taxes. Enough to eliminate the billing departments outside of actual luxury medicine.
As far as cost controls/etc, set by something like a dutch auction within a given metro area, and then some bean counter will get to figure out if it's cost effective to ship people that are outside of metro areas in to them to provide non-urgent care.
Yeah I don't know how it is in the US but in my country everyone is employed on a temporary basis. The days of actually getting a stable job for life are long gone. Getting a two year contract is the best you can get.
> I pay around $400 in health insurance premiums (health, eye, and dental) for a whole family
I would love to pay $400 a month for health care for my entire family all inclusive in the US! Can you please state the name of your insurance company and your specific policy so I can get this too? My rate is over $20,000 a year right now so that would be a tremendous savings. Thank you so much!
> I moved from Denmark to the US, and I pay around $400 in health insurance premiums (health, eye, and dental) for a whole family.
My health alone is $2,100/month for a family of four. I suspect your employer is paying a large portion of your premiums as a benefit.
This is quite common in the US, and a significant portion of the problem, as people think they're getting great insurance "cheap". They're not - it's just being paid in a way that's not visible. As a result, any discussion of "it'd be cheap to implement national healthcare, it'd only cost $X" is met with "but I pay peanuts for mine now!"
I've noticed that a lot of employers don't tell workers how much they are paying for health insurance. Because for large companies the number gets rolled into a negociated contract.
In my case I do know. My employer pays $930 some a month. My rent used to be $860/month.
The other thing the happens is just because you have insurance doesn't mean that healthcare providers aren't trying to jack more money out of you. Any procedure/service will be up coded to increase your out of pocket share.
Yeah I only pay like 20% of the cost of the premium for my plan for my wife and I. Which means the actual premium is over $1k a month... yikes. At least the deductible is only a few hundred dollars...
Ha, that's cheap. Last time I checked the medical system gets over 20 grand a year from me(some via my employer). Works out to like 4 to 7 grand a visit, and that's mostly routine checkups/vaccinations for my kid. There's a reason doctors and medical/insurance execs are so wealthy.
According to the article, workers in Denmark see 26.7% of compensation go to "compulsory payments" including taxes and health care. Workers in US pay 43.2%.
Why should I trust your figures over the article? Are you including the "employer contribution" toward your taxes and health care premiums?
Yeah, that's the thing. The true cost is somewhat hidden because of the employer part of the premium. And the costs you pay out of pocket when an actual health event happens.
I imagine you can still pay $1000+ out of pocket to have a baby in a US hospital, even if you have great insurance.
Also, the article talks "average", while I imagine US health costs are highly variable depending on whether you are young, old, smoker, non-smoker, fat, skinny, pre-existing conditions, etc...
Some people pay $1500 per month in health care. And some, $400.
Can confirm the same in NYC. NYU Hospital with nothing fancy other than delivery of a beautiful Daughter. We had to go back due to some Jaundice but were told to visit NYPH for this instead. I imagine we will be well north of 9000 USD when all is said and done.
Did you check your employers contribution? Because at my US job, I paid around 340$ to insurance but the employer matched it with another 340$ to insurance, so insurance was actually 680$/month. A ridiculously bad deal considering there were still deductibles/out of pocket of a few thousand dollars and some differences based on whether I get in-network or out-of-network treatment.
> In Denmark, only health is covered, so for eye and dental many go out-of-country to get it cheap.
That kinda sucks for Denmark. In Austria, everything is included in the 7.5% that health insurance costs.
Well, in Austria there are a lot of people going to the dentist to Hungary as well because it's cheaper. The situation is a bit more subtle than you pretend it is.
Health insurance typically only covers the minimum at the dentist, and almost nothing of what is considered "cosmetic" or would be good in the long-run (e.g. oral hygiene, braces).
It gets expensive quite fast.
Depends on if the individual's state accepted Medicaid expansion funds from the federal government (states like Texas and Florida haven't) and whether the individual makes less than ~$16.5k/yr.
I wouldn't call either $0k/yr in North Carolina, or $17k/yr in New York, lower middle class. Neither of those incomes in those places would give an individual access to Medicaid.
Every doctor I see is a Medicaid provider. Yes, there are doctor who don't accept it, but it's not hard where I'm from to find a doctor who does (perhaps we have an oversupply of doctors?).
"Medicaid provider" and "Medicaid provider taking new patients" are not the same thing. They'll usually set a maximum number of Medicaid patients for the practice, and there'll be a long waiting list for that.
not only billionaires. How about completely unauditable $700B defense budget producing beauties like F-35 plus additional supplemental couple hundred billions per year on actively establishing and maintaining democracy in a bunch of places far far away!
Then there's education costs in the US, say you want your kid to go to CalArts, that's $50,000 a year just for tuition, so your kid gets out of school $500k in debt with a degree in performance art and a $3,000 a month student loan payment for life.
Including room, board, and books, you're looking at something in the $20,000 range, and it varies a lot by state. If you live in Virginia, for example, undergraduate total cost of attendance for UVA is around $32,000 (https://sfs.virginia.edu/cost/18-19).
EDIT: There is also the case where you may live in a state with insufficient opportunities for higher education. For example, neither of North Dakota's two public research universities (U of ND, ND State) rank inside the US News top 200, and both of those schools will still charge you around $20,000 per year. Germans or Brits will be able to receive subsidized educations at any university in their countries.
I went out of state for university. But I do live in the ND/MN region and I can tell you I know an entire community of NDSU computer science students who graduated and now make over 6 figures. Sure they say it wasn't amazing, but it got the job done for really cheap. Also NDSU is only 7k per year in state before assistance. No idea where you are getting the 20k figure from.
You'd probably have access to a better education at U of M in Minneapolis. But it's going to be quite a bit more expensive and I'm not sure it would have that large effect on your career.
I didn’t have the grades, legacy or extracurricular activities to get into the Ivy League. I could get into good engineering schools, but couldn’t imagine the debt or bankrupting my parents. So I went to a SUNY school, and everything worked out fine.
You'd probably also find the amount of amenities provided by universities ridiculous. I mean we had a free olympic pool and rented puppies to pet before finals. Its no wonder it costs so much
I found a stark difference in German and American higher education that the German higher education system treats you like an adult, including accountability for your own schedule, whereas in comparison American universities appear an extension of middle school. Carefully created and controlled curriculum, etc. That's in no way a statement about the academic merit in either direction, of course.
This is very much aligned with the direct cost and services provided. Attending German universities is virtually free, and under certain conditions, the country will give you very cheap loans to pay for your living expenses. My spouse had a single digit number of thousands of Euros to pay back after graduating.
PhD students are often underpaid employees and are treated that way (for better or worse) instead of being considered as and treated like students. This doesn't imply one is preferable to another, just that it is a continuation of treating them with and expecting a higher degree of maturity and independence.
An upshot for me was that when I applied to my first industry job, the time as a PhD student was treated as work experience.
So yeah, I think you're spot on in that many folks from continental Europe would find the amenities bewildering. :)
Ten years ago in France, it was around 279€ and since my familly was in the lowest quintile, it was covered by the state. But i've hear that the true cost was in fact 3.8K€ per student, up to 7K per student if you count lodging. Or around 10K$.
For "Elite" schools the upfront cost is between 7K and 15K, and you can add 2K for the true cost (paid in taxes, VAT or income) and 3k for lodging. I say elite but the best school in France for math is actually a public university (ranked 5th in the world or around that), and you can get this for almost free if your parents are poor.
In the Swiss system (as I understand it) it's about $600 to attend classes, but if you don't hit the minimum on the semester exams twice, then you're done in the country.
If you miss it the first round then there is a massive incentive to transfer or find an easier program, otherwise you face the prospect of being forced to go abroad to complete a degree.
I would tend to believe it does considering the people I work with from university like the EPFL.
But more generally, it might be a today problem where people has to be hand carried to do anything with 0 critical thinking.
The tuition fee in the UK isn't really a fee at all, at least for most domestic students. In practice, it's more like a graduate tax. Student loans are only repayable if you're earning over £25,725 per year. Your repayments are 9% of your income over that threshold. Your loan is automatically forgiven after 30 years. Because of these terms, the vast majority of students never fully repay their loan.
Actually, if we assume the previously posted £10,000/year, and three years for a Bachelor's they'd have a £30,000 debt. Assuming no interest, since it's only the amount over £25,725 that's taxed they'd have to average £25,725+((£30,000/30)/.09), or £36,836.11, over 30 years to fully repay, which I think is a much more reasonable number outside of HCOL areas.
I'm not sure if they account for inflation or have any fixed interest on the loans. 30 years without any would be pretty crazy.
They have above interest earnings for higher earners, and a lot of students take out loans of nearly twice the size to pay living costs, so a lot of people whose earnings average over £40k in 2019 money won't pay all their loans back either.
Nitpick: you can't really generalize about education in the UK as Scotland has a completely different system to England and Wales (and I don't know about NI).
For example, tuition fees at Scottish universities are "free" (i.e. paid for by the Scottish Government) for Scottish residents and people from other EU countries (but not the rest of the UK).
And the real tuition is that high is because there’s an endless supply of students willing to dump insane amounts of money into a degree program that will, at best, lead to a $40k/year job. Cut the head off the snake and things will come back to earth.
- taking a kid to the ER costs nothing
- taking a kid to a GP or a pediatrician costs nothing
- staying a night at the hospital costs around 15€
- getting a prescription from the pharmacy costs 5€